NIOSH SSS flashcards
NIOSH SSS · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Spirometry indication
- Detect airflow obstruction, confirm or monitor asthma and COPD, grade severity, assess preoperative risk, and screen occupational lung disease.
- Absolute contraindication
- Recent pneumothorax, acute myocardial infarction, or other condition where a forced expiratory maneuver could cause serious harm; defer testing.
- Relative contraindication
- Recent thoracic, abdominal, or ocular surgery, hemoptysis, thoracic aneurysm, or unstable cardiovascular status; weigh risk versus benefit before testing.
- Bronchodilator withholding
- Short-acting beta-agonists 4 hours, long-acting beta-agonists 12 hours, and long-acting anticholinergics 24 hours before testing when reversibility is assessed.
- Calibration verification frequency
- Perform with a 3-L syringe at the start of each testing day and after cleaning, disinfection, or sensor changes; document results.
- Volume accuracy limit
- ATS/ERS 2019 requires volume accuracy within ±3.5% of reading or ±0.05 L, whichever is greater, verified with a calibrated syringe.
- Flow accuracy limit
- Flow accuracy should be within ±5% of reading or ±0.2 L/s, whichever is greater, checked across low, medium, and high flow rates.
- Syringe check tolerance
- A 3-L syringe check must read within ±3.5%, approximately 2.895 to 3.105 L, at multiple flow rates to confirm linearity.
- Biological control
- Periodic testing of a healthy nonsmoking staff member to track longitudinal spirometer performance and detect drift in FEV1 and FVC.
- Height measurement
- Measure standing height without shoes to the nearest 0.5 cm; use measured height rather than self-reported height for reference equations.
- Participant screening
- Review contraindications, medications, recent illness, and smoking status before each session and document the review.
- Testing posture
- Seated upright in a chair with arms, feet flat, head slightly elevated, nose clip in place, and loose clothing loosened.
- Emergency readiness
- Oxygen, bronchodilators, and a means to summon help must be available; staff should be trained in basic life support.
- Maneuver instruction
- Instruct a maximal inhalation, tight lip seal, and a hard fast blast continued for at least 6 seconds until the technologist says stop.
- Coaching technique
- Use enthusiastic, specific verbal coaching during the effort and demonstrate the maneuver; avoid vague encouragement that does not guide effort.
- Exhalation duration
- Coach the forced exhalation for at least 6 seconds and until the volume-time curve plateaus or the participant cannot continue.
- Number of maneuvers
- Attempt at least three acceptable maneuvers and up to eight; stop when reproducibility is met or the participant is fatigued.
- Acceptable maneuver
- Free of cough in the first second, no glottic closure, no leak, satisfactory start, and meeting end-of-test criteria.
- End-of-test criterion
- A volume-time plateau with no change for at least 1 second, or exhalation lasting at least 6 seconds, or the participant cannot continue.
- Reproducibility criterion
- The two largest FVC values and the two largest FEV1 values should each agree within 0.150 L (150 mL).
- Back-extrapolated volume
- BEV should be less than 5% of FVC or 0.150 L, whichever is greater; a larger value indicates a hesitant start.
- Best value selection
- Report the largest FEV1 and largest FVC from acceptable maneuvers; do not average values across maneuvers.
- Obstructive pattern
- FEV1/FVC ratio below the lower limit of normal, with reduced FEV1; severity is graded by FEV1 percent predicted.
- Restrictive pattern
- Reduced FVC with preserved or increased FEV1/FVC ratio; confirmation requires lung volumes such as total lung capacity.
- Severity grading
- FEV1 percent predicted: mild ≥70%, moderate 60–69%, moderately severe 50–59%, severe 35–49%, very severe <35%.
- Bronchodilator response
- An increase in FEV1 or FVC of at least 0.200 L and 12% from baseline, meeting both criteria.
- Lower limit of normal
- The fifth percentile of the reference population; values below LLN are abnormal and account for age, sex, height, and ethnicity.
- Required report elements
- Report FVC, FEV1, FEV1/FVC, FEF25–75%, and PEF with predicted values, LLN, percent predicted, and test quality.
- Record retention
- Store raw data and curves per institutional and regulatory requirements, often at least 7 years or as local law specifies.
- Hand hygiene
- Perform hand hygiene before and after participant contact and between participants; use gloves when handling contaminated components.
- Disposable mouthpiece
- Use a new single-use mouthpiece or filter for each participant; never reuse single-use items between participants.
- Disinfection contact time
- Follow the EPA-registered disinfectant label for concentration and contact time; inadequate contact time reduces effectiveness.